Cystic Acne: 4 Major Causes + 5 Emergency Remedies

If you’re someone who struggles with cystic acne, this article is a must-read! Every woman dreads having their face covered in stubborn blackheads and clogged pores. Among all types of acne, the most troublesome one is cystic acne. Unlike regular pimples, cystic acne lies deep within the skin, has no visible pus, but is incredibly painful. So how should you deal with it to avoid scarring? And what can you do when it flares up? Keep reading to find out!

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What Is Cystic Acne?

Many women have experienced breakouts before. Acne generally forms when pores become clogged with excess oil and bacteria, leading to inflammation of the hair follicles. Cystic acne is the most difficult type to treat. It’s a hormonal acne that can affect people of any age.

Cystic acne tends to be larger and more inflamed than regular acne. It often develops when several inflamed nodules merge into a swollen lump beneath the skin. This type of acne is usually painful, warm to the touch, and feels hard—hence the name “cystic” or “stone-like” acne.

The healing process also takes longer than for regular acne, usually over a month. Because it affects deeper layers of skin, it often leaves behind permanent pitted scars.

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What Are the Characteristics of Cystic Acne?

Cystic acne forms when the sebaceous glands inside the pores become inflamed and blocked. This traps oil and dirt deep within the skin, forming painful nodules. These feel raised and uneven to the touch, and are often accompanied by redness and a dull ache.

Common characteristics:

Characteristic 1: Where It Appears

Cystic acne can develop anywhere on the face, but it tends to break out in oilier areas like the T-zone—especially the chin, forehead, and nose. For women, hormonal changes before menstruation often cause breakouts on the chin. Those with excess stomach heat may develop cystic acne on the cheeks.

Characteristic 2: Appearance

Cystic acne typically lacks a visible pus head, but appears larger and more swollen. It’s a form of nodular acne, meaning several deep nodules fuse into a larger mass. These may remain a dark red color and swell slightly before pus forms, if at all.

Characteristic 3: Texture

True to its name, cystic acne feels hard like a stone. Touching it causes mild pain, and during flare-ups, it can feel warm to the touch.

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What Causes Cystic Acne?

Cystic acne is larger and redder than regular pimples. Common causes include:

Cause 1: Hormonal Imbalance

Cystic acne is closely tied to hormone levels in women. During puberty or around menstruation, hormone fluctuations stimulate excess oil production and skin cell buildup, increasing the chance of clogged pores. Stress, emotional instability, and poor sleep also disrupt hormone balance, contributing to breakouts.

Cause 2: Poor Lifestyle Habits

Late nights, sleeping with makeup on, and a diet high in oily or spicy foods can all trigger cystic acne. Poor facial hygiene also plays a role, making the skin appear dark red and swollen.

Cause 3: Bacterial Infections

Cystic acne often develops from existing acne that worsens. When severe inflammation spreads to nearby sebaceous glands, it forms large nodules. Propionibacterium acnes, a common acne-causing bacteria, thrives in oily skin, worsening inflammation.

Cause 4: Clogged Pores

Excess sebum and dead skin cells can block pores. This leads to whiteheads, blackheads, and other non-inflammatory acne, which, if left untreated, can develop into cystic acne.

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Can Acne Location Reflect Internal Health?

Ever notice cystic acne reappearing in the same spot, even after it heals? That could signal an underlying health issue:

Location 1: Between the Brows or Temples

Linked to stress and poor sleep quality. Inconsistent sleep can disrupt oil production, triggering cystic acne.

Location 2: Chin

Breakouts here may signal digestive issues or hormone imbalance, especially around menstruation.

Location 3: Nose

The nose has larger pores, making it prone to oil buildup. Recurring cystic acne here could indicate hormonal imbalance.

Location 4: Cheeks

From a traditional Chinese medicine perspective, cheek acne may point to spleen and stomach imbalance or excess internal heat. A diet heavy in “heaty” foods can overburden the liver, causing toxin buildup and acne on the cheeks.

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Emergency Remedies for Cystic Acne

Red, swollen cystic acne can be incredibly painful. Since it’s closed and often lacks a visible pus head, try these emergency methods:

Remedy 1: Acne Creams

Over-the-counter creams often contain anti-inflammatory and antibacterial ingredients to ease swelling and pain. Simply apply after cleansing. However, if the acne is hormone-related, creams may not be effective.

Remedy 2: Toner Compress

Use a gentle toner-soaked cotton pad and apply it to the affected area for 5–10 minutes. This can help reduce swelling and discomfort.

Remedy 3: Gentle Exfoliation

Excess dead skin can clog pores and lead to inflammation. Use mild exfoliants to soften the skin before applying anti-inflammatory treatments.

Remedy 4: Acne Patches

These protect the area from external bacteria and absorb fluid to speed healing. However, cystic acne usually lacks pus, and large patches may worsen inflammation if misused.

Remedy 5: Professional Drainage

Lancing can relieve pressure and release trapped bacteria—but only in a sterile environment and performed by a professional. Otherwise, it may worsen inflammation or cause scarring.

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Traditional Chinese Medicine (TCM) Treatments

From a TCM perspective, cystic acne is caused by poor diet, emotional stress, and blood stagnation. Blocked circulation deprives skin of nourishment, leading to painful, deep nodules without pus.

TCM treatment involves diagnosis through observation, questioning, and pulse reading, followed by customized herbal prescriptions to restore internal balance, improve circulation, and prevent recurrence.

One common TCM remedy is Tao Hong Si Wu Tang, which contains ingredients like Chuanxiong (promotes circulation), peach kernel, and safflower—herbs that reduce blood stagnation and inflammation.

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Other Treatment Options for Cystic Acne

If self-care doesn't help, professional treatments may be needed:

Option 1: Laser Therapy

Laser treatments help reduce acne scars, tighten pores, and smooth skin. By shrinking pore size, lasers reduce buildup that can trigger cystic acne.

Option 2: Oral Isotretinoin (Accutane)

Often prescribed for severe cystic or hormonal acne, isotretinoin reduces oil production, speeds up skin turnover, and prevents clogged pores. A typical course lasts 4–6 months, though initial flare-ups and dry skin are common side effects.

Option 3: Chemical Peels (AHA)

High-concentration AHA (alpha hydroxy acid) helps exfoliate dead skin, accelerate cell renewal, and reduce swelling and inflammation.

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How to Prevent Cystic Acne: 4 Key Steps

Since cystic acne often lingers for over a month, prevention is crucial. Follow these four steps to stop it before it starts:

Step 1: Cleanse Thoroughly

Use a mild facial cleanser daily to remove oil and dirt and keep pores clear, reducing inflammation caused by clogged pores.

Step 2: Hydrate Your Skin

Well-hydrated skin maintains oil-water balance, reducing excess oil production. Use natural moisturizers daily and apply hydrating masks weekly.

Step 3: Maintain Healthy Habits

Stick to a regular sleep schedule, avoid staying up late, and eat a balanced diet. Limit greasy foods, and exercise regularly to boost circulation and skin health.

Step 4: Exfoliate Regularly

A thick layer of dead skin can clog pores. Gentle exfoliation clears buildup, promotes healthy skin turnover, and supports overall skin condition.

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Editor’s Review: Is Perfect Medical’s Acne Treatment the Secret to Banish Cystic Acne for Good?

When you want fast and effective acne relief, a professional treatment may be your best bet. Our editor tried the Perfect Medical Acne Treatment—here’s what happened!

Booking was easy. After registering online, a confirmation text was received within 30 minutes. On the appointment day, the editor simply brought the SMS to the clinic for treatment.

Before the procedure, a consultant performed a professional skin analysis to identify acne concerns and explained how the treatment works. Compared to standard acne products, this treatment acts faster by using different applicators for various acne types—including cystic acne, stress acne, chin breakouts, forehead pimples, and blackheads. It vacuums away dead skin and oil while deeply hydrating the skin and boosting collagen production for smoother, clearer skin.